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However, when refluxed, bile acids can induce epithelial-to-mesenchymal cell transformation via vascular endothelial growth factor signalling (Reference Zhang, Agoston and Pham42) and NF-B activation, leading to local inflammation and the abnormal expression of tumour factors (Reference Sasaki, Hajek and Doukas43,Reference Zhang, Ran and Wu44)

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From an anti-inflammatory perspective, BPC-157 has been shown to attenuate the expression of pro-inflammatory cytokines like TNF- and IL-6 in certain inflammatory models